(3 years, 8 months ago)
Lords ChamberMy Lords, we were alert to the issue of housebound priority cohorts from the very beginning, which is why we have put in place mobile vaccine units. We work closely with community pharmacists and GPs in order to take the vaccine to housebound individuals. While we do not report on them publicly, I understand from the front line that the progress of that has gone extremely well.
The issue of areas of deprivation is really troubling. It is often those areas where the disease is most prevalent and where the vaccine rollout has been the slowest. We are working extremely hard with local community groups, faith groups, marketing experts and influencers to get the message through to the right people and to take the vaccine delivery into the right contexts.
My Lords, the vaccination programme has been one bright spot in what has otherwise been a less than illustrious handling of the pandemic, but the number of daily doses administered on Monday fell significantly, week on week, for the fifth day running. Can the Minister explain why? Can he further explain the apparent discrepancy between the vaccination rate in London and other regions of the country? It appears that some regions have a rate 50% higher than London. What are the reasons for that and what is being done to narrow the gap?
My Lords, I do not agree with the noble Lord’s analysis. We are sometimes constrained by supply, but I am reassured that we will hit the targets that I articulated. London has a younger demographic, which is why the rollout percentages can seem lower than in other areas.
(3 years, 10 months ago)
Lords ChamberMy Lords, I will make only two points.
First, if our fellow citizens are being asked to undergo testing and tolerate restrictions, self-isolation, lockdown and so on—I support these measures—how on earth do the Government explain why so many visitors to this country have been able to fly into our airports without testing, self-isolation and lockdown? How do they explain that to people?
Secondly, what consideration is being given to the effect of the restrictive regulations on the terminally ill? Each year, some 225,000 people undergo palliative care in the United Kingdom. Some have only weeks or months to live. To them, every day is like gold dust, yet currently those undergoing such treatment outside hospices are behind some 7 million other people in the queue for vaccinations. Do not the restrictions being placed on that group cry out for a commensurate prioritisation in vaccination?
(3 years, 11 months ago)
Lords ChamberMy Lords, the work of the charity sector in medical research is absolutely fundamental to national progress in this area. However, it too has been hit incredibly hard by Covid. We are having a number of dialogues with medical research sector representatives on how we can help. There will need to be a short, medium and long-term approach to getting back to where we were at the beginning of the year. How we bridge the current funding gap is a source of enormous concern to the department and the NHS. I cannot guarantee that we can necessarily embark on exactly the same framework that we envisaged at the beginning of the year, but I can reassure the noble Lord that we are very committed to the research community and we engage with it regularly on how we can help.
My Lords, several references have been made to our late and much-loved colleague Tessa Jowell, who I was proud to call a friend. Was she not prescient when in her last speech to this Chamber she said:
“I am not afraid. I am fearful that this new and important approach”—
referring to research—
“may be put into the ‘too difficult’ box”. [Official Report, 25/1/18; col. 1170]
When the Minister tells us in all sincerity that it is just too difficult to spend the £40 million that was promised, will he at least give this House an assurance that after this discussion he will take a personal and direct oversight of this matter, because it would be a great tragedy if those words of Tessa Jowell proved to be correct in the long run?
I hear the noble Lord’s words loud and clear. I reassure him that the good news is that Tessa Jowell left behind her in the Tessa Jowell Brain Cancer Mission an incredibly effective organisation that is holding the feet of Ministers firmly to the fire —not least through my noble friend Lord O’Shaughnessy, who is on my case in a very big way.
I recognise that this is one of the tricky scientific challenges of our age. We have struggled to tackle adult brain tumours for a very long time. There has to be investment in the basic science around them, in the techniques, such as the very focused radiology, and in provable therapeutics that work in the field. This is not going to happen overnight, but I reassure the noble Lord that we are committed to finding a solution.
(4 years, 3 months ago)
Lords ChamberMy Lords, the Cabinet Office is charged with the role of deciding the order of priority. There are precedents for this; it is a well-established list that is decided at a level outside the DH. I do not know if Cabinet Ministers are given priority, but I slightly suspect that junior Ministers are not.
My Lords, I will ask about the poorest of our fellow citizens. According to the ONS report last Friday, in the four months March to June this year, the mortality rate for Covid-19 in the most deprived areas of England was 140 deaths per 100,000 people. This was more than double the mortality rate—63 deaths per 100,000 of population—in the best-off areas. In fact, it was 120% above. Even worse, in June the mortality rate in the most deprived areas was 137.5% higher. In short, it is getting worse. Why was there no mention of any of these in the Statements that have been laid before us? What measures are the Government taking to address this particular problem?
The noble Lord touches on a subject that is extremely sensitive—it makes me feel emotional to think about it—but he is entirely right that those who are least advantaged in society are hardest hit by this disease and lots of other diseases. There are behavioural reasons for this: the decisions that people make about social distancing and their own health. There are also environmental reasons: the living conditions and the places in which they live. Neither of these detract from the fact that this is a very sad and upsetting truth. However, we are extremely conscious of the challenge, as we are of all health inequalities. The particular lever that we are focused on is trying to get our message out to hard-to-reach communities, who may not have heard the important messages on hygiene, social distancing and isolation. We have in place a programme of marketing in order to reach these communities to communicate these important messages.
(4 years, 3 months ago)
Lords ChamberMy Lords, I have one minute in which to make one simple point. These are very detailed regulations, but whatever the level of detail, they will not have the intended effect unless the Government’s communication and messaging is clear, concise, unambiguous and constant. Sadly, I am afraid that until now, on lockdown, testing, quarantine, technology, face masks and many other things, Ministers have often appeared to equivocate, dither or delay, and that only confuses the public with mixed messages. I ask the Minister simply that we should please avoid doing that this time. Can we ensure that there is consistency and clarity in messaging, otherwise the effect of these detailed regulations will be lost?
(4 years, 4 months ago)
Lords ChamberMy Lords, social distancing has without doubt been the most effective tool in the battle against Covid. That is why the Prime Minister has appointed the Permanent Secretary, Simon Case, to undertake a review, which will include the Chief Medical Officer and the Chief Scientific Adviser. The use of masks might offer some protection but in no way will it ever replicate the impact of social distancing. That is why we are not prejudging any review or making any assumptions about any changes.
My Lords, some of the Government’s own scientific advisers have said that being one metre apart carries up to 10 times the risk of being two metres apart. Are the Minister and the Government willing to take that risk? If so, will any changes to the two-metre rule be reviewed, assessed and changed if necessary, and how often would such further reviews take place?
The noble Lord’s maths is entirely right. That is why we are moving cautiously in this area, despite many people’s concerns and despite the profound effect on industries such as the hospitality industry, which we regret enormously. However, the main focus is to drive down the infection rate. If we can get the prevalence levels down sufficiently, social distancing will not be required any further, and it is on that target that we are focusing.
(4 years, 4 months ago)
Lords ChamberMy Lords, supporting children and young people’s mental health during and after the pandemic is absolutely a priority. Mental health providers are offering support using digital and remote approaches to continue assessment and treatment during social distancing measures. This is part of the wide range of support that we are providing. The noble Lord is entirely right that this area requires a huge amount of investment; we have committed to making that necessary investment.
My Lords, the Covid pandemic has often been referred to as the invisible enemy. That is all too often true of mental health issues as well. Is the Minister aware that the campaign group Beyond Tomorrow has estimated that 83% of young people have said that the coronavirus pandemic has made their mental health worse? Will he guarantee that all young people and families who need immediate mental health support can get it to prevent the pandemic having long-term consequences for young people’s mental health?
The noble Lord is entirely right to focus on the impact of the pandemic on young people. It is not yet clear how that mental health impact will take effect. The natural concern is that it will be long standing. One thinks back to the major economic shocks of the past, which often led to long-term mental health issues for those who found economic insecurity. The struggle to find jobs left them with damaged confidence and concerns about the future. With that in mind, we are very much focused on addressing young people’s mental health and the impact of the epidemic.
(4 years, 5 months ago)
Lords ChamberMy Lords, I completely hear the noble Earl’s reservations about certification. Our plans are in development. We are fully aware of the concerns that he has expressed about their potentially divisive nature, but the public deserve to know whether they have had the disease. We have to use whatever technology we can to help shake off the economic and social effects of this virus. Therefore, we retain an open mind on the use of certification.
Does the Minister accept that the proposed tracking app we are discussing will effectively exclude those who do not have a smartphone or the experience, knowledge or capability to operate apps or Bluetooth? That will disproportionately exclude the elderly, the poor and the disadvantaged—exactly the groups most at risk from Covid-19. What plans do the Government have to include this group in any future tracking and testing regime?
My Lords, the testing and tracing regime depends on three legs: access to tests; updated methods of the classic contact tracing run by individuals, using phones and the internet; and lastly, importantly but not exclusively, the NHS app. We are very much focused on ensuring that the vulnerable, the elderly and the digitally poor are in no way excluded, which is why we have put the human element at the centre of our plans.
(6 years, 4 months ago)
Lords ChamberIt would be a big mistake for anybody to tell the British people that they voted the wrong way. I point out to the noble Baroness, however, that, whatever was on any side of the bus, as a result of the funding plan announced by the Prime Minister there will be £394 million a week more in real terms for the NHS by 2024. I am also pleased to say that there are more EU staff working in the NHS today than two years ago.
My Lords, the problems and challenges of Brexit will only add to the massive challenges which, in our enthusiasm for the birthday of the NHS, we sometimes underestimate. These include demographic change, an ageing population, new inventions and therapies, new pharmaceutical products and so on. Although I very much welcome extra money, this problem will not be solved just by extra money; it will require massive organisation, radical restructuring, and innovation in technology on a massive scale. That will not be achieved by one party on its own. Why, therefore, do the Government constantly refuse the recommendations of some noble Lords and committees in this House to establish a cross-party consensus on this and take party politics out of it to the maximum extent? That is the only way—accompanied by money—that we can save the NHS for the next 70 years.
The noble Lord knows better than most the challenges of transforming the National Health Service, and is right about the big challenges that we face—although I think it is better to look at them as opportunities. He is also right that reform has to go hand in hand with extra money. We promised the extra money; we now need to see the reform. Every part of the health service—the department, the NHS, and others—needs to drive that through. On his point about consensus, I do not think there is anything stopping that consensus: the Government want consensus. We do not necessarily think that it needs to be in the form of a royal commission or a parliamentary commission. We want to work with all corners of this House and the other place to make sure that there is support for a broad plan for the NHS for the next 10 years.
(6 years, 8 months ago)
Lords ChamberThe noble Baroness is quite right to highlight this issue. There simply are not equivalent waiting times for CAMHS. As she mentioned, we have introduced the first waiting times for eating disorders and early intervention in psychosis. I think she will have been pleased to have seen in the Green Paper published before Christmas that a new four-week waiting time for NHS children and young people’s mental health services will be piloted. That will be rolled out in the near future.
My Lords, in the eight years before 2010, waiting lists and waiting times were brought down dramatically. In the eight years since 2010, waiting times and waiting lists have risen dramatically. What does the Minister think happened in 2010 to change that?
I think we all know what happened in 2010, but it might be worth pointing out that 10 years ago, half of patients waited more than 18 weeks for referral to treatment and that is now only about 10%.